Health issues for gay men and men who have sex with men

All men face certain health risks. However, gay men and men who have sex with men have some specific health concerns.

Although your individual risks are shaped by many factors beyond your sexual orientation and practices — including family history and age — it's important to understand common health issues for gay men and steps you can take to stay healthy.

Protect yourself from sexually transmitted infections

Men who have sex with men are at increased risk of contracting HIV, the virus that causes AIDS, as well as other sexually transmitted infections, including hepatitis, human papillomavirus (HPV), herpes simplex, gonorrhea, chlamydia and syphilis.

To protect yourself from sexually transmitted infections:

Use a condom or other protection. Use a new latex or polyurethane condom every time you have sex, especially during anal sex but ideally during oral sex as well.

Use only water-based lubricants, not petroleum jelly, hand lotion, cold cream or oils. Oil-based lubricants can weaken latex condoms and cause them to break. Don't share sex toys, and keep them safe by protecting them with a condom and cleaning them before and after every use.

Be monogamous. Another reliable way to avoid sexually transmitted infections is to stay in a long-term mutually monogamous relationship with a partner who isn't infected.

Limit the amount of alcohol you drink, and don't use drugs. If you're under the influence, you're more likely to take sexual risks. If you choose to use injectable drugs, don't share needles.

Know the risks associated with sexual venues. Sexual venues such as bathhouses, sex parties and the Internet can facilitate multiple sexual partnerships and anonymous sexual encounters, as well as higher risk sexual behaviors.

Get vaccinated. Vaccinations can protect you from hepatitis A and hepatitis B, serious liver infections that can spread through sexual contact.

Not all sexually transmitted infections are prevented by vaccines, however. Hepatitis C is not covered by any vaccine and can lead to liver failure, liver cancer and death. The HPV vaccine is available to men up to age 26. HPV is associated with anal cancer in men who have sex with men.

Get tested and have your partner tested. Don't have unprotected sex unless you're certain you and your partner aren't infected with HIV or other sexually transmitted infections.

Testing is important because many people don't know they're infected, and others might not be honest about their health.

Different types of tests have a different "window period," the period of time between HIV infection and when signs of the infection show up on a test. Being tested during this time might result in a false negative. It is possible to transmit the HIV infection to someone during this period.

Consider the drug Truvada. In July 2012, the Food and Drug Administration (FDA) approved the use of the drug emtricitabine-tenofovir (Truvada) to reduce the risk of sexually transmitted HIV infection in those who are at high risk. Truvada is also used as an HIV treatment along with other medications.

When used to help prevent HIV infection, Truvada is only appropriate if your doctor is certain you don't already have an HIV or hepatitis B infection. The drug must also be taken daily exactly as prescribed. And it should only be used along with other prevention strategies such as condom use every time you have sex.

Tackle depression

Gay men and men who have sex with men might be at higher risk of depression and anxiety. In addition, youth who identify themselves as lesbian, gay, bisexual or transgender might have a higher risk of depression and attempted suicide.

Contributing factors could include social alienation, discrimination, rejection by loved ones, abuse and violence. The problem might be more severe for men who try to hide their sexual orientation and those who lack social support.

Left untreated, depression can lead to risky sexual behavior and a downward spiral of emotional, behavioral, health, and even legal and financial problems. If you think you might be depressed, talk to your doctor or seek help from a mental health provider.

If you're reluctant to seek treatment, confide in a trusted friend or loved one. Sharing your feelings might be the first step toward getting treatment.

Address body image concerns

Gay men are more likely to experience body image problems and eating disorders, such as anorexia and bulimia nervosa, than are their straight counterparts.

One potential explanation is that gay men identify with the cultural value placed on an ideal — yet often unattainable — body image. Gay men might also be more likely to view their bodies as sexual objects, which can lead to dissatisfaction and poor body image.

If you're struggling with body image concerns or an eating disorder, get help. Talk to your doctor or a mental health provider about treatment options.

The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Institute of Medicine. http://www.iom.edu/. Accessed June 24, 2014.

What gay, bisexual and other men who have sex with men need to know about sexually transmitted diseases. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. http://www.cdc.gov/std/life-stages-populations/STDFact-MSM.htm. Accessed June 24, 2014.

Feldman MB, et al. A group intervention to improve body image satisfaction and dietary habits in gay and bisexual men living with HIV/AIDS. Eating Disorders: The Journal of Treatment and Prevention. 2011;19:377.

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